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PubMed1975

Factors affecting the choice between prepaid group practice and alternative insurance programs.

This paper examines the basis for the selection of prepaid group practice in a dual-choice situation, and the social, attitudinal, and health characteristics of populations choosing prepaid programs in contrast to other plans. When asked in an open-ended way why they made the decisions they did, those selecting prepaid group practice most frequently referred to the more comprehensive coverage provided and to the fact that at the time of choice they lacked a continuing or adequate relationship with a physician. Enrollees in the prepaid program were better educated and, contrary to previous research, more likely to be unmarried. There was little evidence that enrollees in the prepaid plan brought with them distinctive kinds of attitudes and orientations toward illness and medical care. Enrollees in the prepaid program were also comparable to those retaining an alternative health insurance option on a number of indicators of health status. However, prepaid practice enrollees tended to report more chronic conditions than persons who declined to enroll in the prepaid program. Although the overrepresentation of persons with chronic illnesses is not large, data drawn from a related study suggests that persons with several chronic conditions tend to be heavy users of medical services.

Adult↗
PubMed2001

Want to perfect your company's service? Use behavioral science.

It may seem like the topic of service management has been exhausted. Legions of scholars and practitioners have applied queuing theory to bank lines, measured response times to the millisecond, and created cults around "delighting the customer." But practitioners haven't carefully considered the underlying psychology of service encounters--the feelings that customers experience during these encounters, feelings often so subtle they probably couldn't be put into words. Fortunately, behavioral science offers new insights into better service management. In this article, the authors translate findings from behavioral-science research into five operating principles. First, finish strong: the ending is far more important than the beginning of an encounter because it's what remains in the customer's memory. Second, get the bad experiences out of the way early: in a series of events, people prefer to have undesirable events come first and to have desirable events come last. Third, segment the pleasure, combine the pain: since experiences seem longer when they are broken into segments, it's best to combine all the boring or unpleasant steps of a process into one. Fourth, build commitment through choice: people are happier when they believe they have some control over a process, particularly an uncomfortable one. And fifth, give people rituals and stick to them: most service--encounter designers don't realize just how ritualistic people are. Ultimately, only one thing really matters in a service a encounter--the customer's perception of what occurred. This article will help you engineer your service encounters to enhance your customers' experiences during the process as well as their recollections of the process after it is completed.

Behavioral Sciences↗
PubMed2003

How to inject consumerism into your existing health plans.

Consumerism seeks to create a behavior change on the part of consumers so that they become accountable, knowledgeable and actively engaged in managing their health. It can be used in any existing health plan through targeted plan design changes and consumer education efforts. Employers have many options in addition to consumer-directed health plans (CDHPs).

Communication↗
PubMed2003

Parental evaluation of quality of life measures following pediatric dental treatment using general anesthesia.

The purpose of this study was to examine (a) parental satisfaction with the dental care their child received under general anesthesia, and (b) perception of the impact of this care on physical and social quality of life. The sample included 45 children (median age 50 months, 26 boys and 19 girls). Data were collected using a 1-page survey instrument completed by the parent at the first follow-up appointment. Dichotomous dependent variables were developed to measure parental satisfaction, dental outcome, and social impact of treatment. There was an overwhelmingly positive impression with dental outcomes (pain relief and improved masticatory efficiency). Parental perceptions in the social dimension were also positive. Parents reported more smiling, improved school performance, and increased social interaction. Relative to overall health, the majority of parents reported an improvement. Logit regression analysis revealed that absence of pain (P < .05) and increased social interaction (P < .01) had a significant impact on parents' perception of overall health. Our findings indicate that dental care under general anesthesia for preschool children has a high degree of acceptance by parents and is perceived to have a positive social impact on their child.

Anesthesia, Dental↗
PubMedDate not supplied

Manage your human sigma.

If sales and service organizations are to improve, they must learn to measure and manage the quality of the employee-customer encounter. Quality improvement methodologies such as Six Sigma are extremely useful in manufacturing contexts, but they're less useful when it comes to human interactions. To address this problem, the authors have developed a quality improvement approach they refer to as Human Sigma. It weaves together a consistent method for assessing the employee-customer encounter and a disciplined process for managing and improving it. There are several core principles for measuring and managing the employee-customer encounter: It's important not to think like an economist or an engineer when assessing interactions because emotions inform both sides' judgments and behavior. The employee-customer encounter must be measured and managed locally, because there are enormous variations in quality at the work-group and individual levels. And to improve the quality of the employee-customer interaction, organizations must conduct both short-term, transactional interventions and long-term, transformational ones. Employee engagement and customer engagement are intimately connected--and, taken together, they have an outsized effect on financial performance. They therefore need to be managed holistically. That is, the responsibility for measuring and monitoring the health of employee-customer relationships must reside within a single organizational structure, with an executive champion who has the authority to initiate and manage change. Nevertheless, the local manager remains the single most important factor in local group performance. A local manager whose work group shows suboptimal performance should be encouraged to conduct interventions, such as targeted training, performance reviews, action learning, and individual coaching.

Behavioral Sciences↗
PubMed1987

Selection of a physician for prenatal care.

The selection of a physician for prenatal care was studied as a model of the generic process of choosing a physician. The results suggest that factors important in this process are similar to those relating to satisfaction with care: physician competence, cost and convenience, and personal qualities. Women selecting obstetricians for prenatal care placed a higher emphasis on physician competence, whereas those selecting family physicians placed a greater emphasis on cost and convenience.

Adult↗
PubMed1994

Contraceptive implants.

Available contraceptive implants appeal to women of diverse cultural and socioeconomic background because they offer long-term contraception, safety, effectiveness, reversibility and lack of estrogenic side-effects. Experience with Norplant I indicates that despite some side-effects the continuation rate is the highest for any reversible method of contraception. Disruption of the menstrual cycle is the main reason for discontinuation, hence research effort needs to focus on the mechanism of progestogen-induced endometrial bleeding and appropriate therapy. Implant service programs should have trained and skilled personnel who can provide adequate counseling that complements any public education effort and also provides effective services. Because contraceptive implants offer no protection against sexually transmitted infections, those who engage in high-risk sexual behavior should be encouraged to use condoms as well.

Adolescent↗
PubMed1992

The effect of consumer perceptions on generic OTC usage among the elderly.

The rise of generic alternatives to branded over-the-counter products in the U.S. posits new strategic positioning challengers to marketers. Health care marketers who employ an "imitation strategy" have captured market share by emulating market leaders' product attributes. This implicitly calls for an understanding of the influence that consumers' product perceptions have on their choice of OTC offerings. This study investigates the influence of an elderly sample's perceptions of generic OTC characteristics on their adoption behavior.

Aged↗
PubMed2002

Can high quality overcome consumer resistance to restricted provider access? Evidence from a health plan choice experiment.

OBJECTIVE: To investigate the impact of quality information on the willingness of consumers to enroll in health plans that restrict provider access. DATA SOURCES AND SETTING: A survey administered to respondents between the ages of 25 and 64 in the West Los Angeles area with private health insurance. STUDY DESIGN: An experimental approach is used to measure the effect of variation in provider network features and information about the quality of network physicians on hypothetical plan choices. Conditional logit models are used to analyze the experimental choice data. Next, choice model parameter estimates are used to simulate the impact of changes in plan features on the market shares of competing health plans and to calculate the quality level required to make consumers indifferent to changes in provider access. PRINCIPAL FINDINGS: The presence of quality information reduced the importance of provider network features in plan choices as hypothesized. However, there were not statistically meaningful differences by type of quality measure (i.e., consumer assessed versus expert assessed). The results imply that large quality differences are required to make consumers indifferent to changes in provider access. The impact of quality on plan choices depended more on the particular measure and less on the type of measure. Quality ratings based on the proportion of survey respondents "extremely satisfied with results of care" had the greatest impact on plan choice while the proportion of network doctors "affiliated with university medical centers" had the least. Other consumer and expert assessed measures had more comparable effects. CONCLUSIONS: Overall the results provide empirical evidence that consumers are willing to trade high quality for restrictions on provider access. This willingness to trade implies that relatively small plans that place restrictions on provider access can successfully compete against less restrictive plans when they can demonstrate high quality. However, the results of this study suggest that in many cases, the level of quality required for consumers to accept access restrictions may be so high as to be unattainable. The results provide empirical support for the current focus of decision support efforts on consumer assessed quality measures. At the same time, however, the results suggest that consumers would also value quality measures based on expert assessments. This finding is relevant given the lack of comparative quality information based on expert judgment and research suggesting that consumers have apprehensions about their ability to meaningfully interpret performance-based quality measures.

Adult↗
PubMed2006

Consumer choice in Dutch health insurance after reform.

This article investigates the scope and effects of enhanced consumer choice in health insurance that is presented as a cornerstone of the new health insurance legislation in the Netherlands that will come into effect in 2006. The choice for choice marks the current libertarian trend in Dutch health care policymaking. One of our conclusions is that the scope of enhanced choice should not be overstated due to many legal and non-legal restrictions to it. The consumer choice advocates have great expectations of the impact of enhanced choice. A critical analysis of its impact demonstrates that these expectations may not become true and that enhanced consumer choice should not be perceived as the 'magic bullet' for many problems in health care.

Choice Behavior↗
PubMed2002

The next big thing in health benefits: consumer choice.

Consumers are the only ones who can affect all decision points that drive health care cost and quality. As a result, consumers' health and financial security depend on their taking more responsibility for their health care decisions and having the tools and information needed to do so successfully. This article explains the five key decision points that drive health care cost and quality, how technology aids marketplace innovations, and how employers can help advance consumer choice in order to push the health care system to deliver better care and keep inflation in check.

Choice Behavior↗
PubMed2002

Choice of and overall satisfaction with pharmacies among a community-dwelling elderly population.

OBJECTIVES: To identify factors related to elderly consumers' choice of pharmacy types and their overall satisfaction with pharmacy services provided by: a single community pharmacy, multiple pharmacies with a primary community pharmacy, a single mail order pharmacy, and multiple pharmacies with a primary mail order pharmacy. DATA: Data were extracted from the Texas Tech 5000 survey of consumers, age 65 years or older, in West Texas. The survey contains information about the respondents' health services use, pharmacy service use, satisfaction with accessibility and quality, health insurance coverage, health beliefs, health status, and demographics, as well as other health-related factors. METHODS: An endogenous treatment effect model was used to examine elderly consumers' choice of and satisfaction with different types of pharmacies. The first stage of the estimation identified factors related to consumers' choice of pharmacies. The second stage estimated the effects of pharmacy types on consumers' overall satisfaction with pharmacy services, controlling for self-selection. RESULTS: The type of pharmacy was a significant determinant of satisfaction. Self-selection was found in the determination of consumers' overall satisfaction with pharmacy services. Controlling for self-selection, elderly consumers who used a single community pharmacy and who used multiple pharmacies with a primary mail order pharmacy were the most satisfied with their pharmacy services. The type of pharmacy that ranked lowest in overall consumer satisfaction was multiple pharmacies with a primary community pharmacy. Insurance coverage of prescription drugs was significantly associated with consumers' choice of pharmacy. The greater the number of prescription drugs a consumer took, the higher the odds were that they used multiple pharmacies. CONCLUSIONS: Although using a single community pharmacy may create close patient-pharmacist relationships and improve health outcomes, consumers may be diverted from this choice because of price concerns and insurance diversification.

Aged↗
PubMed2005

Using contingent choice methods to assess consumer preferences about health plan design.

INTRODUCTION: American insurers are designing products to contain health care costs by making consumers financially responsible for their choices. Little is known about how consumers will view these new designs. Our objective is to examine consumer preferences for selected benefit designs. METHODS: We used the contingent choice method to assess willingness to pay for six health plan attributes. Our sample included subscribers to individual health insurance products in California, US. We used fitted logistic regression models to explore how preferences for the more generous attributes varied with the additional premium and with the characteristics of the subscriber. RESULTS: High quality was the most highly valued attribute based on the amounts consumers report they are willing to pay. They were also willing to pay substantial monthly premiums to reduce their overall financial risk. Individuals in lower health were willing to pay more to reduce their financial risk than individuals in better health. DISCUSSION/CONCLUSION: Consumers may prefer tiered-benefit designs to those that involve overall increases in cost sharing. More consumer information is needed to help consumers better evaluate the costs and benefits of their insurance choices.

Adult↗
PubMed2005

Implicit attitudes towards genetically modified (GM) foods: a comparison of context-free and context-dependent evaluations.

Past research on attitudes towards GM food has focused on measuring explicit attitudes. Here we compared implicit attitudes towards GM foods with explicit attitudes towards GM foods. We used the Go No-Go task to investigate context-free implicit evaluations of GM foods and compared these with evaluations made in the context of ordinary and organic foods. Semantic differential scales were used to evaluate explicit attitudes towards GM foods. As expected, explicit attitudes towards GM foods were found to be neutral. However, contrary to our hypotheses, participants were found to hold positive, rather than neutral, implicit attitudes towards GM foods when these were assessed in a context free manner. In addition, neutral implicit attitudes were found when attitudes were assessed in the context of ordinary or organic foods, again contrasting with our hypotheses. These results imply that implicit attitudes towards GM food are more positive than anticipated and may lead to approach behaviour towards such products. Thus, given the choice, consumers are likely to accept GM food although other incentives may be needed if alternative foods are available.

Attitude↗